A global model for effective use and evaluation of e-learning in health.

Healthcare systems worldwide face a wide range of challenges, including demographic change, rising drug and medical technology costs, and persistent and widening health inequalities both within and between countries. Simultaneously, issues such as professional silos, static medical curricula, and perceptions of "information overload" have made it difficult for medical training and continued professional development (CPD) to adapt to the changing needs of healthcare professionals in increasingly patient-centered, collaborative, and/or remote delivery contexts. In response to these challenges, increasing numbers of medical education and CPD programs have adopted e-learning approaches, which have been shown to provide flexible, low-cost, user-centered, and easily updated learning. The effectiveness of e-learning varies from context to context, however, and has also been shown to make considerable demands on users' motivation and "digital literacy" and on providing institutions. Consequently, there is a need to evaluate the effectiveness of e-learning in healthcare as part of ongoing quality improvement efforts. This article outlines the key issues for developing successful models for analyzing e-health learning.

Vulnerability assessment of buildings subject to tunnel-induced settlements: the influence of orientation and position of the building

The assessment of settlement induced damage on buildings during the preliminary phase of tunnel excavation projects, is nowadays receiving greater attention. Analyses at different levels of detail are performed on the surface building in proximity to the tunnel, to evaluate the risk of structural damage and the need of mitigation measures. In this paper, the possibility to define a correlation between the main parameters that influence the structural response to settlement and the potential damage is investigated through numerical analysis. The adopted 3D finite element model allows to take into account important features that are neglected in more simplified approaches, like the soil-structure interaction, the nonlinear behaviour of the building, the three dimensional effect of the tunnelling induced settlement trough and the influence of openings in the structure. Aim of this approach is the development of an improved classification system taking into account the intrinsic vulnerability of the structure, which could have a relevant effect on the final damage assessment. Parametric analyses are performed, focusing on the effect of the orientation and the position of the structure with respect to the tunnel. The obtained results in terms of damage are compared with the Building Risk Assessment (BRA) procedure. This method was developed by Geodata Engineering (GDE) on the basis of empirical observations and building monitoring and applied during the construction of different metro lines in urban environment. The comparison shows a substantial agreement between the two procedures on the influence of the analysed parameters. The finite element analyses suggest a refinement of the BRA procedure for pure sagging conditions.